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Medical billing and coding specialists work in one of America’s fastest growing professions. These workers fall under the broader U.S. Bureau of Labor Statistics (BLS) category of medical secretaries; Collectively, this area has an expected employment increase of 8% between 2021 and 2031, resulting in 53,600 new jobs. Demand is expected to increase as the aging population requires more healthcare services.
Medical Billing And Coding Specialist Schools
Every healthcare facility needs someone to handle medical billing and coding for insurance and patient billing. Doctors or office managers may perform these tasks in addition to their other responsibilities, or they may hire one or more employees to perform these tasks. Because clinical staff focus on patient care, it is often the job of trained specialists to manage the important administrative work of billing and coding to ensure that providers are reimbursed for their services.
Steps To Become A Medical Coder And Biller
Does the idea of working as a billing and coding specialist sound appealing to you? Let’s take a look at what it takes to make it in this fast-growing industry.
A billing and coding specialist helps the healthcare organization manage insurance claims, billing, and payments. The daily work of a medical coding and billing specialist includes:
Although these employees often work in the same healthcare facility where patients go for treatment, this is primarily an office job, as opposed to patient-centered clinical work. A medical billing and coding specialist will spend a lot of time on the computer reviewing, entering and updating information.
Job descriptions often combine billing and coding into a single position. However, technically they are two different functions, each with its own responsibilities and duties.
Medical Coding & Billing
Many healthcare offices will hire the same person to perform both tasks, but larger facilities may split the task into two separate functions. So it is important to understand the difference between the two roles.
Medical coding is the act of collecting a healthcare provider’s diagnostic and procedural notes and converting them into the appropriate codes for record keeping and billing purposes. The codes are alphanumeric combinations common in the industry and are used to identify the services provided and billed. This requires knowledge of the different codes used:
Each of these codes is used in insurance billing, and the coder must follow specific guidelines for proper use and placement in the billing software.
Codes can be entered as soon as the patient makes an appointment. There are codes for the type of visit and the complaints reported by the patient. Further codes are applied to the symptoms observed by the medical staff, the tests and procedures performed, the diagnoses and treatments recommended.
Reasons To Start A Medical Billing And Coding Career: Professional Development: Indiana University South Bend
After coding is complete, medical billing specialists generate invoices and send the claims to the patient’s insurers (or other payers). Based on these codes, insurance companies will approve or deny payment requests. The remaining amount not covered by insurance is then sent to the patient for payment.
The billing process often begins once the patient makes an appointment with the medical office, as codes can be entered and submitted to an insurer for approval. This helps determine what the patient’s out-of-pocket expenses will be so that the office can bill the patient for that amount at the time of the visit.
A medical imager must understand the industry codes even if someone else is doing the coding, because the billing specialist must review the reasons behind all denied insurance claims and is responsible for updating the codes before resubmitting claims. A medical biller will also verify that the codes have been entered correctly before submitting the initial claim.
Once the insurance bill is paid, the patient will be billed for the remaining balance. This process is also the responsibility of the medical billing specialist. Medical billing also determines copayment requirements, tracks payments, and tracks outstanding payments from insurance companies and patients.
Best Medical Billing And Coding Degree Programs Of 2023
If an invoice remains unpaid, the billing specialist should contact the insurance companies and check that all documents are in order. If a patient does not pay an outstanding bill within a certain period of time and does not respond to further requests, the billing specialist must turn the debt over to a collection agency.
Because the billing and coding processes are so intertwined, many medical offices hire billing and coding specialists with the training to perform both roles. While some larger facilities hire separate teams to handle billing and coding, these individuals typically work very closely together to ensure the process is done correctly. The most important aspect is avoiding billing and coding errors so that payments are collected on time.
Although job titles and descriptions may vary for a career as a medical billing and coding specialist, the basic requirements are often the same. Familiarity with the necessary codes is a general requirement, but there are other areas of knowledge that will increase your chances of getting hired.
To code correctly, a basic understanding of medical terminology is essential. This includes anatomy and physiology terms, diagnostic and procedure terminology, etc. Understanding the most commonly used terms in the medical profession aids in the billing and coding process.
How Do I Get A Job In Medical Billing?
To determine the correct invoice amounts, you must be able to do basic arithmetic. Although the billing system can automatically populate forms with the correct insurance claim amounts based on the codes entered, you may need to calculate remaining patient prescribed amounts or, if applicable, set up payment plans.
The medical billing and coding process requires a working knowledge of computer systems and relevant medical software. The ability to learn new programs is also a plus.
Part of the medical billing process may include contacting patients for payment. The ability to communicate effectively and professionally is necessary for this aspect of the job. Some patients may be stressed, upset, or angry when faced with medical problems and a big bill, so good communication skills can make these conversations a little easier.
In addition to computer skills, a medical billing and coding specialist must also use other basic equipment such as a 10-key calculator, printer, copier, scanner, telephone system and the like. If you’ve ever worked in an office environment, you’ve probably used these tools.
Companies That Hire For Remote Medical Coding Jobs
While certification is not required by every employer to get a job as a medical billing and coding specialist, having an industry certification, such as the Certified Professional Coder (CPC®) credential from the AAPC, can help you stand out as an applicant. in the field.
Although work experience and other eligibility requirements are necessary for full CPC certification, those who pass the certification exam but do not have the required experience may receive the CPC Apprentice (CPC-A) designation. After demonstrating two years of work experience or 80 contact hours of a coding preparation course plus one year of experience, a CPC student can obtain full CPC status.
The BLS reports that the average salary for a medical secretary, which includes medical imagers and coders, was $37,450 per year in 2021. That means half of medical billing and coding specialists make more than that amount and half make less.
The top 10% in this range earned more than $63,100 and may reflect the salary levels of those with more work experience. The bottom 10% (lowest decile) of earners in this area earn an average of $29,040 and $13.96 per hour, which may reflect work experience closer to entry level. UMA graduates in the 2021-2022 cohort of its medical billing and coding programs reported to UMA as earning an average hourly wage at or slightly above the BLS’s lowest decile.
Medical Coding Salary
As you gain experience in the field, you can earn more, especially if you move into senior or supervisory positions.
A medical billing and coding specialist requires good organizational skills. If you are a detail-oriented professional who is able to manage time well and handle multiple projects expertly, then a job in medical billing and coding may be for you.
Candidates must also be comfortable in an office environment, as the job requires a lot of time behind a computer screen and with patient records. It is important to have a good command of medical terminology, or at least be willing to learn it. Employees in this area also need to stay abreast of changes in procedures and coding guidelines, so an interest in further learning is also a good quality for this role.
If this description sounds like you, training to become a medical billing and coding specialist may be a good career choice.
The Top 15 Accredited Medical Coding And Billing Online Schools
Billing and coding opportunities may be available to those without formal training or experience, but some medical offices prefer experience or certification (or in some cases both) from a billing and coding specialist. Earning a degree or diploma in medical billing and coding can help you gain the necessary knowledge
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